| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $29.91 | $29.91 | $29.91 | |
Aetna
| Professional | $29.91 | $29.91 | $32.90 | |
Cigna
| Facility | $29.91 | $29.91 | $29.91 | |
Cigna
| Professional | $29.91 | $29.91 | $29.91 | |
United
| Professional | $26.92 | $29.91 | $29.91 |